Published on June 9, 2023
Dr. Vishal Kulkarni (Consultant Medical Oncologist, Hemato-Oncologist and Transplant Physician), HCG NMR, Hubli
Cervical cancer is a significant global health issue, affecting millions of women worldwide. Human papillomavirus (HPV) infection is a major risk factor for the development of cervical cancer. Fortunately, the introduction of HPV vaccines has revolutionized cervical cancer prevention and control strategies. HPV is a common sexually transmitted infection, with more than 100 different types identified. Certain high-risk types, such as HPV-16 and HPV-18, are responsible for approximately 70% of all cervical cancer cases. Persistent infection with these high-risk HPV types can lead to the development of precancerous lesions, which, if left untreated, may progress to invasive cervical cancer over time.
The Role of HPV Vaccines:
HPV vaccines are designed to prevent infection with high-risk HPV types, thereby reducing the risk of cervical cancer. Currently, there are three HPV vaccines available: Gardasil, Gardasil 9, and Cervarix. These vaccines target various HPV types, including those responsible for most cases of cervical cancer. They work by stimulating the immune system to produce antibodies that neutralize the virus, preventing its entry into cells and subsequent infection.
Impact on Cervical Cancer Incidence:
Since the introduction of HPV vaccination programs in many countries, significant reductions in HPV infection rates and cervical cancer incidence have been observed. Studies have shown that vaccinated populations have lower rates of HPV infection and precancerous lesions compared to unvaccinated populations. One of the remarkable advantages of HPV vaccination is the potential for herd immunity. By vaccinating a significant portion of the population, the transmission of HPV can be significantly reduced, protecting both vaccinated and unvaccinated individuals. This population-level effect has been demonstrated in numerous studies, highlighting the importance of high vaccination coverage to achieve maximum benefits in terms of cervical cancer prevention.
Impact on Cervical Cancer Screening:
HPV vaccination complements existing cervical cancer screening programs. While vaccination reduces the overall burden of HPV infection and related diseases, it does not eliminate the risk entirely. Therefore, regular cervical cancer screening, such as Pap smears or HPV testing, remains essential, even for vaccinated individuals. However, vaccinated individuals may benefit from reduced screening frequency or modified screening algorithms, as the risk of developing precancerous lesions is significantly lower.
What if you don’t belong to the recommended vaccine age group?
HPV vaccine is administered in a 2-dose schedule for ages 9-14 and 3 dose schedule for those over 15years with catch up age up to 26 years. But nevertheless, it is approved for usage even up to age 45 years with definitely some benefit irrespective of being sexually active or not. For those who do not belong to the recommended age group, there are still several important steps they can take to protect themselves from the disease.
HPV vaccination has had a profound impact on cervical cancer prevention and control. It has demonstrated efficacy in reducing HPV infections, precancerous lesions, and cervical cancer incidence. Combined with effective cervical cancer screening, HPV vaccination offers a comprehensive approach to reducing the burden of this disease globally. Continued efforts to improve vaccine accessibility, increase awareness, and ensure high vaccination coverage are essential for maximizing the benefits of HPV vaccination and achieving significant progress in cervical cancer prevention and control.